Twin Birth Considering the Current Results of the “Twin Birth Study”

Abstract

The rate of caesarean sections in multiple births has grown sharply worldwide. The reason for this may be the results of large retrospective cohort studies from the 1990s, which displayed an increased risk of mortality and morbidity, especially for the second twin, in the case of vaginal births. Multiple monocentric analyses have not been able to confirm this. As a prospective, multi-centre randomised study, the Twin Birth Study published in 2013, in which 105 clinics in 25 countries took part, showed that, under optimum conditions, there was no difference in neonatal and maternal mortality and morbidity if the birth was planned to be vaginal or via caesarean. Detailed analyses, which would be helpful in choosing the type of birth method and obstetric management in the event of vaginal birth, have not previously been published. Retrospective studies must be referred to for this.

Zusammenfassung

Die Sectiorate bei Geminigeburten ist weltweit steil angestiegen. Der Grund dafür dürften die Ergebnisse großer retrospektiver Kohortenstudien aus den 90er-Jahren sein, die ein erhöhtes Mortalitäts- und Morbiditätsrisiko, insbesondere für den 2. Zwilling bei vaginaler Geburt gezeigt haben. Mehrere monozentrische Analysen konnten dies nicht bestätigen. Als prospektive multizentrische randomisierte Studie zeigt nun die 2013 publizierte Twin Birth Study, an der 105 Kliniken in 25 Ländern teilnahmen, dass unter optimalen Bedingungen kein Unterschied in der neonatalen und mütterlichen Mortalität und Morbidität besteht, wenn die Geburt vaginal oder als Kaiserschnitt geplant war. Detaillierte Analysen, die hilfreich für die Wahl des Geburtsmodus und das geburtshilfliche Management bei vaginaler Geburtsleitung wären, sind bisher nicht veröffentlicht. Hier muss man sich weiter an retrospektiven Studien orientieren.

Key words

Twin Birth Study - twin birth - breech presentation - caesarean rates

Schlüsselwörter

twin birth study - Zwillingsgeburt - Beckenendlage - Sectiorate

• References

• 1 Hannah ME, Hannah WJ, Hewson SA et al. Planned caesarean versus planned vaginal birth for breech presentation at term: a randomized multicentre trial. Lancet 2000; 21: 1375-1383
• 2 Kotaska A. Inappropriate use of randomised trials to evaluate complex phenomena: case study of vaginal breech delivery. BMJ 2004; 329: 1039-1042
• 3 Krause M. Der Term Breech Trial: Aufstieg und Fall einer internationalen, multizentrisch randomisierten, kontrollierten Studie – eine kritische Bilanz. Z Geburtsh Neonatol 2006; 210: 121-125
• 4 Glezerman M. Five years to the Term Breech Trial: The rise and fall of a randomized controllled trial. Am J Obstet Gynecol 2006; 194: 20-25
• 5 ACOG Committee Opinion. Mode of term singleton breech delivery. Obstet Gynecol 2006; 109: 235-237
• 6 Lee HC, Gould JB, Boscardin WJ et al. Trends in cesarean delivery for twin births in the United States. Obstet Gynecol 2011; 118: 1095-1101
• 7 Kyvernitakis A, Kyvernitakis I, Karageorgiadis AS et al. Rising cesarean rates of twin deliveries in Germany from 1990 to 2012. Z Geburtshilfe Neonatol 2013; 217: 177-182
• 8 van der Garde M, Winkens B, Roumen FJ. Increased elective caesarean section rate is not associated with a decreased serious morbidity rate for twins ≥ 32 weeksʼ gestation. J Obstet Gynaecol 2012; 32: 453-457
• 9 Smith GCS, Sha I, White I et al. Mode of delivery and the risk of delivery-related perinatal death among twins at term: a retrospective cohort study of 8073 births. Int J Obstet Gynecol 2005; 112: 1139-1144
• 10 Smith GC, Pell JP, Dobbie R. Birth order, gestational age, and risk of delivery related perinatal death in twins: retrospective cohort study. BMJ 2002; 325: 1004
• 11 Smith GC, Fleming KM, White IR. Birth order of twins and risk of perinatal death related to delivery in England, Northern Ireland, and Wales, 1994-2003: retrospective cohort study. BMJ 2007; 334: 576
• 12 Wen SW, Fung Kee Fung K, Oppenheimer L et al. Neonatal mortality in second twin according to cause of death, gestational age, and mode of delivery. Am J Obstet Gynecol 2004; 191: 778-783
• 13 Yang Q, Wen SW, Chen Y et al. Neonatal mortality and morbidity in vertex-vertex second twins according to mode of delivery and birth weight. J Perinatol 2006; 26: 3-10
• 14 Armson A, OʼConnell C, Persad V et al. Determinants of perinatal mortality and serious neonatal morbidity in the second twin. Obstet Gynecol 2006; 108: 556-564
• 15 Herbst A, Källen K. Influence of mode of delivery on neonatal mortality in the second twin, at and before them. BJOG 2008; 115: 1512-1517
• 16 Schmitz T, Carnavalet C, Azria E et al. Neonatal outcome of twin pregnancy according to the planned mode of delivery. Obstet Gynecol 2008; 111: 695-703
• 17 Dudakova A. Geburtshilfliches Management und fetales Outcome bei Mehrlingsschwangerschaften in der Klinik St. Hedwig in Regensburg 2000 – 2008. Inauguraldissertation zur Erlangung des Doktorgrades der Medizin der Fakultät für Medizin der Universität Regensburg. 2013
• 18 Rossi AC, Mullin PM, Chmait RH. Neonatal outcomes of twins according to birth order, presentation and mode of delivery: a systematic review and meta-analysis. BJOG 2011; 118: 523-532
• 19 Barrett JFR, Hannah ME, Hutton EK et al. A randomized trial of planned cesarean or vaginal delivery for twin pregnancy. N Engl J Med 2013; 369: 1295-1305
• 20 Hofmeyer GJ, Barrett JF, Crowther CA. Planned caesarean section for women with a twin pregnancy. Cochrane Database Syst Rev 2011; (12) CD006553
• 21 Rabinovici J, Barkai G, Reichman B et al. Randomized management of the second nonvertex twin: vaginal delivery or caesarean section. Am J Obstet Gynecol 1987; 156: 52-56
• 22 Steins Bisschop CN, Vogelvang TE, May AM et al. Mode of delivery in non-cephalic presenting twins: a systematic review. Arch Gynecol Obstet 2012; 286: 237-247
• 23 Atis A, Aydin Y, Donmez M et al. Apgar scores in assessing morbidity of the second neonate of cephalic/non-cephalic twins in different delivery modes. J Obstet Gynaecol 2011; 31: 43-47
• 24 Winn HN, Cimino J, Powers J et al. Intrapartum management of nonvertex second-born twins: a critical analysis. Obstet Gynecol 2001; 185: 1204-1208
• 25 Sibony O, Touitou S, Luton D. Modes of delivery of first and second twins as a function of their presentation. Study of 614 consecutive patients from 1992 to 2000. EJOG 2006; 126: 180-185
• 26 Persad VL, Baskett TF, OʼConnell C et al. Combined vaginal-cesarean delivery of twin pregnancies. Obstet Gynecol 2001; 98: 1032-1037
• 27 Engelbrechtsen L, Nielsen EH, Perin T et al. Cesarean section for the second twin: a population-based study of occurrence and outcome. Birth 2013; 40: 10-16
• 28 Molkenboer JF, Bouckaert PX, Roumen FJ. Recent trends in breech delivery in the Netherlands. BJOG 2003; 110: 948-951
• 29 Abu-Heija AT, Ziadeh S, Obeidat A. Mode of delivery and perinatal results of the breech first twin. J Obstet Gynaecol 1998; 18: 47-49
• 30 Blickstein I, Goldman RD, Kupferminc M. Delivery of breech first twins: a multicenter retrospective study. Obstet Gynecol 2000; 95: 37-42
• 31 Sentilhes L, Goffinet F, Talbot A et al. Attempted vaginal versus planned caesarean delivery in 195 breech first twin pregnancies. Acta Obstet Gynecol 2007; 86: 55-60
• 32 Oettinger M, Ophir E, Markovitz J et al. Is cesarean section necessary for delivery of a breech first twin?. Gynecol Obstet Invest 1993; 35: 38-43
• 33 Grisaru D, Fuchs S, Kupfermine MJ et al. Outcome of 306 twin deliveries according to first twin presentation and method of delivery. Am J Perinatology 2000; 17: 303-307
• 34 Roopnarinesingh AJ, Sirjusingh A, Baasaw B et al. Vaginal breech delivery and perinatal mortality in twins. J Obstet Gynaecol 2002; 22: 291-293
• 35 Nassar AH, Maarouf HH, Hobeika EM et al. Breech presenting twin A: is vaginal delivery safe?. J Perinat Med 2004; 129: 470-474
• 36 Pharaoah PO, Adi Y. Consequences of in utero death in a twin pregnancy. Lancet 2000; 355: 1597-1602
• 37 Glinianaia SV, Obeysekera MA, Sturgiss S et al. Stillbirth and neonatal mortality in monochorionic and dichorionic twins: a population based study. Hum Reprod 2011; 2549-2557
• 38 Roqué H, Gillen-Goldstein J, Funai E et al. Perinatal outcomes in monoamniotic gestations. J Matern Fetal Neonatal Med 2003; 13: 414-421
• 39 Dodd JM, Crowther CA. Should we deliver twins electively at 37 weeksʼ gestation?. Curr Opin Obstet Gynecol 2005; 17: 579-583
• 40 Lopriore E, Holtkamp N, Sueters M et al. Acute peripartum twin-twin transfusion syndrome: incidence, risk factors, placental charateristics and neonatal outcome. J Obstet Gynaecol Res 2014; 40: 18-24
• 41 Sau A, Chalmers S, Shennan AH et al. Vaginal delivery can be considered in monochorionic and diamniotic twins. BJOG 2006; 113: 602-604
• 42 Hoffmann E, Oldenburg A, Rode L et al. Twin births: cesarean section or vaginal delivery?. Acta Obstet Gynecol Scand 2012; 91: 463-469
• 43 Pestana I, Loureiro T, Almeida A et al. Effect of mode of delivery on neonatal outcome of monochorionic diamniotic twin pregnancies: a retrospective cohort study. J Reprod Med 2013; 58: 15-18
• 44 Erdemoglu E, Mungan T, Tapisiz O et al. Effect of inter-twin delivery time on Apgar scores of the second twin. Aust N Z J Obstet Gynaecol 2003; 43: 203-206
• 45 Hartley RS, Hitti J. Birth order and delivery interval: analysis of twin pair perinatal outcomes. J Matern Fetal Neonatal Med 2005; 17: 375-380
• 46 Leung TY, Tam WH, Leung TN et al. Effect of twin-to-twin delivery interval on umbilical cordblood gas in second twin. BJOG 2002; 109: 63-67
• 47 McGrail CD, Bryant DR. Intertwin time interval: How it affects the immediate neonatal outcome of the second twin. Am J Obstet Gynecol 2005; 192: 1420-1422
• 48 Stein W, Misselwitz B, Schmidt S. Twin-to-twin delivery time interval: influencing factors and effect on short-term outcome of the second twin. Acta Obstet Gynecol Scand 2008; 87: 346-353
• 49 Bartnicki J, Meyenburg M, Saling E. Time interval in twin delivery – the second twin need not always be born shortly after birth. Gynecol Obstet Invest 1992; 18: 19-20
• 50 Rayburn WF, Lavin JP, Miodovnik JP et al. Multiple gestation: time interval between delivery of the first and second twins. Obstet Gynecol 1984; 63: 502-506
• 51 Rydhstrom H, Ingemarsson I. Interval between birth of the first and the second twin and its impact on second twin perinatal mortality. J Perinat Med 1990; 18: 449-453
• 52 Briese V, Falker U, Plesse R et al. Analyse von 122 Gemini-Entbindungen unter besonderer Berücksichtigung des zweiten Zwillings. Zentralbl Gynäkol 1994; 116: 38-43
• 53 Schneuber S, Magnet E, Haas J et al. Twin-to-twin delivery time: neonatal outcome of the second twin. Twin Res Hum Genet 2011; 14: 573-579
• 54 Edris F, Oppenheimer L, Yang Q et al. Relationship between intertwin delivery interval and metabolic acidosis in the second twin. Am J Perinatol 2006; 23: 481-486
• 55 Fox NS, Silverstein M, Bender S et al. Active second-stage management in twin pregnancies undergoing planned vaginal delivery in a U.S. population. Obstet Gynecol 2010; 115: 229-233
• 56 Vogel JP, Torloni MR, Seuc A et al. Maternal and perinatal outcomes of twin pregnancy in 23 low- and middle-income-countries. PLoS One 2013; 8: e70549